We owe it to our malnourished patients to be better at discharge planning.

Starting any business is hard, expensive and the likelihood of failure is high. I’m not sure what the odds in the health technology space are (don’t tell me) but I’ve had several people say to me that I must be crazy to start a health tech company which is developing specialist software to help in the delivery of clinical nutrition. After making the significant decision to resign from a permanent position as a Senior University Lecturer, it may very well appear to be true. However, the following quote really resonates with me when it comes to what we are trying to do with Nutrition Cloud:

“When something is important enough, you do it even if the odds aren’t in your favour”
– Elon Musk (His mother is a dietitian!)

We are now 18 months into our Nutrition Cloud journey and we have a prototype, several research projects planned, a dietitian who has started her PhD in the area of mHealth and the management of malnutrition and we are currently talking to a number of potential customers, partners and/or collaborators. All of this is very exciting but I cannot emphasise how much work has been put in by the team outside of their work, study, research and family life. Being a dietitian with a PhD in the area of malnutrition and having had a grandparent die due to secondary complications brought on by malnutrition, it’s probably been easier for me to remain motivated in the face of reduced income, savings and lack of sleep. For the technical and developer experts in the Nutrition Cloud team, clinical nutrition and malnutrition can be quite abstract, especially when the media focuses on the other end of the spectrum. Luckily, we are all passionate about the potential impact that well designed, user-focused software can have on the lives of patients and their wider support network when nutritional support and dietitian advice is needed. In addition, research such as the one below, published in the Journal of Human Nutrition and Dietetics are great to unpack and discuss with the team as it strengthens our purpose of why we started Nutrition Cloud in the first place.

Best practice clinical nutrition saves lives, therefore it stands to reason that carefully designed software that is able to leverage dietetic expertise and support patients and their families, also has the potential to save lives. We think that’s a purpose worth working towards, even if the odds prove to not be in our favour.

The research from the United States below investigated the standard of post-discharge care of malnourished inpatients getting discharged from hospital. Unfortunately, the findings are similar to those that have been reported across nearly 500 hospitals in the UK, hospitals in Sweden, Denmark and Norway. That is up to 80% of malnourished inpatients leave hospital without an adequately coordinated nutritional discharge summary. With the vast majority of malnutrition at any one time, found in our communities and care homes this is a concern and undoubtedly impacts on the true clinical and economic value that well coordinated nutritional care can offer.

The current study found:

❌ Almost half of patients received general advice that did not address malnutrition

❓Despite 88% of the malnourished patients receiving oral nutritional supplements (ONS) during their hospitalisation, only 6.6% were continued post-discharge. This is despite a diagnosis of malnutrition almost certainly remaining. However, the authors reassuringly highlight that this was due to electronic discharge processes rather than clinician judgement.

Watch this space for updates on Nutrition Cloud and our journey in developing software that not only supports dietitians to coordinate nutritional care, but puts patients and their wider support network (e.g. family, carer) at the centre to ensure they are supported throughout the entire continuum of care, hospital to home.